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SPECIAL FOCUS ON AGE-RELATED MACULAR DEGENERATION, ORIGINAL ARTICLE
Year : 2021  |  Volume : 69  |  Issue : 3  |  Page : 642-646

Characterization of age-related macular degeneration in Indian donor eyes


1 Department of Stem Cell Biology, Aravind Medical Research Foundation, Dr G. Venkataswamy Eye Research Institute, Madurai, Tamil Nadu, India; Centre for Vision Sciences, Queen's University of Belfast, Belfast; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, U.K
2 Vitreo-Retinal Services, Aravind Eye Hospital, Chennai, Tamil Nadu, India
3 Department of Pathology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
4 Department of Stem Cell Biology, Aravind Medical Research Foundation, Dr G. Venkataswamy Eye Research Institute, Madurai; Department of Human Genetics and Molecular Biology, Bharathiyar University, Coimbatore, Tamil Nadu, India
5 Centre for Vision Sciences, Queen's University of Belfast, Belfast, U.K
6 Department of Stem Cell Biology, Aravind Medical Research Foundation, Dr G. Venkataswamy Eye Research Institute, Madurai, Tamil Nadu, India

Correspondence Address:
Prof. Muthukkaruppan Veerappan
Aravind Medical Research Foundation, Dr. G. Venkataswamy Eye Research Institute, Madurai, Tamil Nadu – 625020
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_291_20

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Purpose: The purpose of this study was to test the reliability of fundus stereomicroscopy in postmortem eyes to assign severity of age-related macular degeneration (AMD) using the Minnesota grading and confirmation by histology using Alabama and Sarks grading scales and to assess the incidence of AMD pathology in donor eyes from a South Indian population. Methods: Eyes (199) from 153 donors (55–95 years) after obtaining fundus images were processed for histology. Fundus images were graded according to the Minnesota grading system based on drusen size, area of depigmentation, and atrophy. At least one eye from each donor displaying the AMD phenotypes were subjected to histological examination. The fundus grading was correlated with histology and the stages of AMD assigned for early AMD by the Alabama AMD grading system and for both early and advanced AMD by the Sarks classification. Results: Stereoscopic examination of the fundus found that 10 of the 153 donors had features of early AMD and 3 advanced AMD. Following histological examination, one of the early AMD eyes was reclassified as advanced AMD. Early AMD features that were observed on histology included soft drusen (>63 μm), basal laminar deposits, photoreceptor outer segment degeneration, disorganization of retinal pigment epithelium (RPE), Bruch's membrane thickening. Advanced AMD features observed in histology are extensive atrophy of RPE, choroidal neovascularization and disciform scar formation. Conclusion: Identification of either early or advanced AMD using stereomicroscopic assessment (SMA) showed high sensitivity and specificity. However, misclassification between AMD stages can occur when only SMA is used.


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